Prevention of Egg Allergies in Infants with Eczema

A Japanese research group found that a stepwise, two-dose introduction of heated egg powder from 6 months of age with extensive eczema treatment was more effective than placebo in the prevention of egg allergies in infants with higher risk.

Food allergies are getting more and more common, and one of the most prevalent amongst them is egg allergy. Early-onset eczema might be a sign of a higher risk of developing food allergies. Research has shown that early introduction of food allergens may be able to decrease the risk of food allergy, even in high-risk infants. However, a safe method for introduction is still needed.

In a study, recently published in The Lancet, a research group investigated the effects of a two-step, increased dose introduction of heated egg powder to infants from 6 to 12 months of age. They included 147 infants who had eczema and were 4-5 months old. They excluded infants who had been born prematurely, those who had already ingested egg products, and infants with previous allergic reactions to egg. Participants were randomly assigned to either the egg, or the placebo group. In the egg group, participants consumed 50mg of heated egg powder and squash daily from 6 to 9 months of age and then 250mg of egg powder and squash from 9 to 12 months. In the placebo group, infants consumed squash only. At 6 months and 9 months, before introducing or increasing the amount of egg powder, participants received an oral food challenge test and were observed for 2 hours. During the study, the participants` eczema was treated to achieve remission. At baseline, 9 months and 12 months, blood samples were drawn to measure egg-specific immunoglobulin content that is associated with immunoreaction to egg proteins.

The study was cut short because researchers found a significant difference between the incidence of egg allergies in the two groups. At 12 months, 8% of infants presented egg allergies in the egg group, while 38% cases were seen in the placebo group. Furthermore, egg-specific IgE concentration was higher in the placebo group, whereas the groups did not differ in other immunoglobulin concentrations. The severity of eczema decreased in both groups from baseline to 12 months. There was no acute reaction to the test powder, but a few participants developed an adverse effect after the first ingestion.

In conclusion, this study showed that eggs could be introduced to high-risk infants in a two-step, two-dose method using heated egg powder, and that the early introduction and eczema treatment might be effective in the prevention of egg allergies.